COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal
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COVID-19 Update
NOVEMBER 19, 2020
QUESTIONS: VCHELP@FNTN.CA
Outline
1. COVID-19 in Alberta
◦ Dr. Deena Hinshaw, Chief Medical Officer of Health – Alberta Health
◦ Amy Colquhoun, Manager, Population Health Assessment - Alberta Health
◦ Lea Bill, Executive Director - Alberta First Nations Information Governance Centre
2. FNIHB MOH Update
◦ Dr. Wadieh Yacoub and Dr. Chris Sarin
3. Alberta Indigenous Virtual Care Clinic
◦ Michelle Hoeber, Program Lead, Telehealth – TSAG
4. Questions
QUESTIONS: VCHELP@FNTN.CA
COVID-19 in Alberta
Dr. Deena Hinshaw (Ministry of Health)
Trish Merrithew-Mercredi (Ministry of Health)
Lea Bill (Alberta FNIGC)
Amy Colquhoun (Ministry of Health)
November 19, 2020
Classification: Protected A
Agenda
1. Overview of COVID-19 data and reporting in Alberta
2. COVID-19 in First Nations People in Alberta
3. Questions: Health Zones, Maps, Testing Approach, Contact Tracing
4. AFNIGC: community data approaches
4
Classification: Protected A
COVID-19: data sources
Sources Information (examples)
Public Health Laboratory • Number of people tested
(ProvLab) • Number of tests completed
• Results of tests (e.g. positive)
Communicable Disease & • Cases and their contacts
Outbreak Management (CDOM) • Outbreaks
• Deaths
Alberta Health Services Analytics • Hospital (ICU and nonICU) admission and
team (DIMR) discharge
Alberta Health Disease Registry • Pre-existing conditions (comorbidities)
Alberta Health Care Insurance • COVID-related information among First
Plan (historic fees) Nations in Alberta
5
Classification: Protected A
COVID-19: daily reporting (examples)
• Cases: new, active, recovered
6
Classification: Protected A
COVID-19: daily reporting (examples)
• Severe Outcomes:
– Hospitalizations (ICU, nonICU)
– Deaths
– Comorbidities
7
Classification: Protected A
COVID-19: daily reporting (examples)
• Testing: people tested, number of tests, percent positivity
8
Classification: Protected ACOVID-19: First Nations report
• Available via email and
on the AFNIGC website
(afnigc.ca)
• Contains less
information compared
to ‘all Alberta’
dashboard due to
potential confidentiality
issues
9
Classification: Protected ACOVID-19: First Nations report
All Alberta First Nations in Alberta
Classification: Protected ACOVID-19: First Nations report
First Nations in
All Alberta
Alberta
• First Nations people more likely to be hospitalized
11
Classification: Protected A
• First Nations people experiencing severe outcomes are youngerQuestions: Health Zone
Rate of active cases
Number of active cases (factors in population size)
160 450
North Zone North Zone
140 400
Edmonton Zone Edmonton Zone
COVID-19 active case rate (per 100,000)
350
Number of active COVID-19 cases
120 Central Zone Central Zone
Calgary Zone 300
100 Calgary Zone
South Zone
250 South Zone
80
200
60
150
40
100
20 50
0 0
3/4/2020 4/4/2020 5/4/2020 6/4/2020 7/4/2020 8/4/2020 9/4/2020 10/4/2020 11/4/2020 3/4/2020 4/4/2020 5/4/2020 6/4/2020 7/4/2020 8/4/2020 9/4/2020 10/4/2020 11/4/2020
12 First Nations in Alberta
Classification: Protected AQuestions: Health Zone
Cases had the following types of exposure:
- 37% (558/1,523) were a close contact
of a known case
- 44% (668/1,523) had an unknown
exposure
- 16% (237/1,523) were linked to an
outbreak
- 4% (60/1,523) were related to travel
13
Classification: Protected AQuestions: maps
• Two different
geographies:
municipality and local
geographic area
• Total cases, active
cases, recovered,
deaths
14
Classification: Protected AQuestions: maps
• Relaunch map
• Municipalities only
(except in Edmonton and
Calgary)
• Threshold: more than 10
active cases and a rate
of 50 or more (per
100,000)
• Enhanced measures in
place
15
Classification: Protected AQuestions: testing approach
• Recent change to focus testing capacity on highest
value testing
– Symptomatic, Outbreaks, and Known Exposures
• In high risk situations, MOHs can authorize targeted
expanded testing for a limited time
– e.g. gathering with an unknown number of exposures
• Testing value is highest with fast turn around times –
increasing speed is the reason for focused testing
16
Classification: Protected AQuestions: AHS contact tracing change
• With increased case numbers, AHS contact tracers
are not able to keep up.
• Until capacity is increased, cases will be asked to
notify their own contacts except for priority settings
(health care and continuing care).
• An online portal to make contact tracing more
efficient has been activated as of last week.
17
Classification: Protected AAlbertaFNIGC
• Sit on the advisory committee for COVID-19 testing
• Distribute information on AlbertaFNIGC website regarding
weekly counts as received from Alberta Health
• Created an educational document – “COVID-19 Information
for First Nations in Alberta” that is available on the
AlbertaFNIGC website (afnigc.ca)
• Provide links to updated research documents, websites, and
reputable scientific YouTube videos to explain COVID-19
and any ongoing developments
18
Classification: Protected AQuestions?
VCHELP@FNTN.CA
https://www.alberta.ca/covid-19-alberta-data.aspx
Classification: Protected AAppendix 20 Classification: Protected A
COVID-19 Vaccine
Government of Canada is tracking all potential drugs and vaccines in
development in Canada and abroad.
Only vaccines that are safe and effective will be approved for use in Canada.
Because there will be limited quantities at first, once a vaccine is approved for
use, key populations will need to be prioritized.
◦ Governments will work together and continue to seek input from independent experts, like
the National Advisory Committee on Immunization (NACI), to make decisions about how to
prioritize vaccination
QUESTIONS: VCHELP@FNTN.CACOVID-19 Vaccine
Key priority populations include:
- Those at high risk of severe illness and death from COVID-19
- Those most likely to transmit COVID-19 to those at high risk of severe illness and death from
COVID-19 and workers essential to maintaining the COVID-19 response
- Those contributing to the maintenance of other essential services for the functioning of society
- Those whose living or working conditions put them at elevated risk of infection and where
infection could have disproportionate consequences, including Indigenous communities
QUESTIONS: VCHELP@FNTN.CACOVID-19 Vaccine
Resources:
GOC: What you need to know about the COVID-19 vaccine for Canada
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/awareness-
resources/know-vaccine.html
GOC: Drugs and vaccines for COVID-19: List of authorized clinical trials
https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-
treatments/list-authorized-trials.html
GOC: Preliminary guidance on key populations for early COVID-19 immunization
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-
naci/guidance-key-populations-early-covid-19-immunization.html
WHO: Coronavirus disease (COVID-19): Vaccines
https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines?gclid=Cj0KCQiA-
rj9BRCAARIsANB_4AAxOObqLWgELI_aRRKE8mHuBXJzfxyZze3E-RdyCfC1vkgJT0rpk5caAsR2EALw_wcB
QUESTIONS: VCHELP@FNTN.CATargeted Public Health Measures
New targeted public health measures were announced on November 12.
Targeted measures apply to all communities on the enhanced list (purple zones).
Additional measures may apply to the Calgary and Edmonton areas, and the
cities of Fort McMurray, Grande Prairie, Lethbridge and Red Deer.
Unless otherwise indicated, measures are in place until we see less stress on our
health care system.
See GOA COVID-19 Info for Albertans website for more information:
https://www.alberta.ca/enhanced-public-health-measures.aspx
QUESTIONS: VCHELP@FNTN.CAMandatory Targeted Public Health Measures
All enhanced Calgary & Edmonton Fort Grande Lethbridge Red Deer
(purple) zone Area & Area McMurray Prairie
areas
15-person limit on family &
social gatherings (CMOH 36-
2020)
50-person limit on wedding
and funeral services (indoor &
outdoor) (CMOH 37-2020)
Ban on indoor group fitness
classes & team sports (Nov
13-27) (CMOH 37-2020)
Ban on group singing, dancing
& performing activities (Nov
13-27) (CMOH 37-2020)
Restaurants/pubs stop liquor
sales by 10pm, close by 11pm
(Nov 13-27) (CMOH 37-2020)
QUESTIONS: VCHELP@FNTN.CAVoluntary Targeted Public Health Measures
All enhanced Calgary & Edmonton & Fort Grande Lethbridge Red Deer
(purple) zone Area Area McMurray Prairie
areas
Mask use encouraged in
all indoor workplaces
Employers in office
settings to reduce
employees in the
workplace at one time
Faith-based gatherings
limited to 1/3 capacity
Limit of 3 cohorts, plus
child care
No social gatherings
inside your home or
outside of your
community QUESTIONS: VCHELP@FNTN.CAIndoor Gathering Limits
Social Gatherings Audience Event
Mandatory Limit (applies to communities on the enhanced Mandatory Limit for wedding and funeral services (applies to
list): 15 people communities on the enhanced list): 50 people
CMOH Order 36-2020 CMOH Order 37-2020
Limit (for communities not on the enhanced list): Voluntary Limit (communities on the enhanced list): Faith-
50 people based gatherings limited to 1/3 capacity at one time
Limit on seated audience event (for communities not on the
enhanced list): 100 people
Social gatherings are where people: Audience-type events are where people:
- move freely to mix with others - are seated spectators of an organized performance or activity
- have two-way conversations - maintain 2 metres distance from others
- share food, laugh, play games - limit movement and interaction with others
- receive one-way information (not conversational)
QUESTIONS: VCHELP@FNTN.CAReminder - Enforcement of Public Health Orders
Individuals who violate a public health order may be subject to a $1,000 fine. Courts can also
administer fines up to $100,000 for a first offence and up to $500,000 for a subsequent offence
for more serious violations.
If you are concerned someone is not following public health orders:
• Remind the person that not following public health orders is against the law and puts people at
risk.
• Speak with your local Community Health Nurse or CDC Case Manager.
• Submit a complaint to Alberta Health Services health inspectors online or by calling 1-833-415-
9179. Complaints that require an immediate response can also be reported to your local police
force.
QUESTIONS: VCHELP@FNTN.CAFNIHB MOH Update
DR. WADIEH YACOUB, SENIOR MEDICAL OFFICER OF HEALTH
DR. CHRIS SARIN, DEPUTY MEDICAL OFFICER OF HEALTH
QUESTIONS: VCHELP@FNTN.CAReminder - Privacy
All information related to an individual who is or was infected with a
communicable disease shall be treated as private and confidential
No information shall be published, released or disclosed in any manner
that would be detrimental to the personal interest, reputation or privacy
of that individual.
QUESTIONS: VCHELP@FNTN.CACurrent Situation – Canada (as of November 18)
Public Health Agency of Canada https://health-infobase.canada.ca/covid-19/dashboard/?stat=rate&measure=total_last14&map=hr&f=true#a2
QUESTIONS: VCHELP@FNTN.CACOVID-19 Across On-Reserve First Nations
Communities Canada by Status (All Provinces)
Source: FNIHB COVID-19 Epi Update (November 18, 2020)
QUESTIONS: VCHELP@FNTN.CACOVID-19 in First Nations in Alberta (on Reserve
Only)
Source: FNIHB COVID-19 ER System via Synergy in Action (November 18, 2020)
847 399 32 38 11
Confirmed and Males Impacted Hospitalized ICU ever
Probable cases communities ever
ever
19 4 512 330 5
Communities Currently Recovered Active Deaths
with active in Hospital
cases
Total Cases by Treaty Area Treay 6
390 285 172 Treaty 7
Treaty 8
0 100 200 300 400 500 600 700 800 900
QUESTIONS: VCHELP@FNTN.CAAge and gender distribution of on-reserve COVID-
19 cases in comparison to all Alberta
Source: FNIHB COVID-19 ER System via Synergy in Action (November 18, 2020)
ALL ALBERTANS FIRST NATIONS (ON RESERVE)
Source:
https://www.alberta.ca/stats/cov
id-19-alberta-statistics.htm
(November 17, 2020)
QUESTIONS: VCHELP@FNTN.CASevere Outcomes
Sources: FNIHB COVID-19 ER System via Synergy in Action (November 18, 2020) &
https://www.alberta.ca/stats/covid-19-alberta-statistics.htm (November 17, 2020)
QUESTIONS: VCHELP@FNTN.CATest Volume
Sources: Community Reports to FNIHB-AB (November 18, 2020)
QUESTIONS: VCHELP@FNTN.CAContributing Factors to Increased Cases
Sources: Community Reports to FNIHB-AB (November 18, 2020)
Gatherings
Non-essential travel
Community transmission
Challenges with isolation (Non-compliance)
Occupational exposure
Overcrowding
QUESTIONS: VCHELP@FNTN.CAImportant Reminders/
Updates
QUESTIONS: VCHELP@FNTN.CAAlberta COVID-19 Testing Criteria
Testing is available to:
◦ any person exhibiting any symptoms of COVID-19
◦ all close contacts of confirmed COVID-19 cases
◦ all workers and/or residents at specific outbreak sites
Asymptomatic testing has been paused for people who have no known
exposure to COVID-19.
FNIHB MOHs will provide guidance to prioritize testing in First Nation
communities with cases.
QUESTIONS: VCHELP@FNTN.CAReminder – Preventing Transmission in
Healthcare Settings
Preventing the risk of transmission amongst staff and clients/patients remains important.
Measures to prevent transmission in healthcare settings should continue to include:
- continuous masking (HCWs must wear a medical mask [procedural/surgical]),
- staff and client screening,
- restricting the number of staff and clients/patients in the setting at any one time;
- physical distancing between all individuals at all times;
- enhanced cleaning/disinfection
QUESTIONS: VCHELP@FNTN.CAUpdated Guidance – Non-Medical Masks
and Face Coverings
A non-medical mask or face covering can be homemade or purchased, and should:
◦ be made of at least 3 layers
◦ 2 layers should be tightly woven material fabric, such as cotton or linen
◦ the third (middle) layer should be a filter-type fabric, such as non-woven polypropylene fabric
◦ Filters add an extra layer of protection against COVID-19 by trapping small infectious particles. Consider
wearing a mask that includes a filter or filter material as one of its layers, such as:
◦ non-woven polypropylene fabric, which can be found as:
◦ a craft fabric
◦ the non-woven fabric that's used to make some reusable shopping bags
◦ a disposable filter inserted into a pocket on the mask
Reusable masks with a non-woven filter layer should be washed daily, and can be washed multiple
times. Disposable filters should be changed daily or as directed by the manufacturer.
Source: Public Health Agency of Canada https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/about-non-
medical-masks-face-coverings.html#_blank
QUESTIONS: VCHELP@FNTN.CAOutbreak-Related Definitions
Outbreak is defined as: “The occurrence of cases of disease in excess of what would normally be
expected in a defined community, geographical area or season” (World Health Organization,
2018).
◦ NOTE: A common source of infection or the identification of transmission between cases are not
requirements for an outbreak. The epidemiologic features of an outbreak and subsequent public health
actions are assessed through the outbreak investigation process.
Alert: A warning sign that the situation may evolve into an outbreak. The threshold for triggering
an alert is dependent on the specific setting.
Public Reporting: The minimum number of cases marking the threshold for public reporting of
COVID-19 outbreaks.
QUESTIONS: VCHELP@FNTN.CADefinition of an Outbreak of COVID-19 by Setting
Type of Setting Alert Outbreak Public Reporting
Congregate Settings One symptomatic resident One confirmed case Two confirmed cases
(Continuing Care, Long-term or staff member
Care, Group home, DSL)
Child Care Facilities One confirmed case OR two Two confirmed cases Five confirmed cases
(Daycares, Head Start, etc.) symptomatic individuals (staff/child) within 14 days
within 48 hours or two confirmed cases that
are epidemiologically linked
Schools One confirmed case Two confirmed cases within Five confirmed cases
a 14 day period where
disease could have been
acquired or transmitted in
the school
Public Settings n/a Five confirmed cases Five confirmed cases
(Restaurants, Rec Centres,
etc.)
QUESTIONS: VCHELP@FNTN.CAUpdate - COVID-19 Alberta Health Daily
Checklist (For Children Under 18)
This new screening checklist (as of November 2) applies for all children, as well as all students
who attend kindergarten to Grade 12, including high school students over 18.
Children should be screened every day by completing this checklist before going to school, child
care or other activities.
Children may need a parent or guardian to assist them to complete this screening tool.
The checklist can be found at: https://open.alberta.ca/publications/covid-19-information-
alberta-health-daily-checklist
QUESTIONS: VCHELP@FNTN.CAAlberta Indigenous Virtual Care Clinic
(AIVCC)
The Alberta Indigenous Virtual Care Clinic (AIVCC) has opened its virtual doors.
◦ Provides services to rural and urban First Nations, Métis and Inuit patients and families
◦ Provides same day, primary care services
◦ Services provided through a secure telephone and/or video system.
◦ Official public launch December 1, 2020
To book a same day appointment, please call 1.888.342.4822.
For more information please see:
◦ www.aivcc.ca or email info@aivcc.ca
◦ Facebook page - Alberta Indigenous Virtual Care Clinic
QUESTIONS: VCHELP@FNTN.CAIs there a topic you
would like to hear about
at the next session?
P LEAS E LE T US KNOW!
E MAIL: VCHELP@FN TN .CA OR
S AC.CDEMERGE N CIES A B - URGE N CES M TA B .IS C @ C ANA DA .CA
QUESTIONS: VCHELP@FNTN.CAInterested in presenting
your community’s COVID-
19 response/experience?
P LEAS E LE T US KNOW!
E MAIL: VCHELP@FN TN .CA OR
S AC.CDEMERGE N CIES A B - URGE N CES M TA B .IS C @ C ANA DA .CA
QUESTIONS: VCHELP@FNTN.CAAcknowledgments
Dr. Deena Hinshaw, Chief Medical Officer of Health - Alberta Health
Lea Bill, Executive Director - Alberta First Nations Information Governance Centre
Amy Colquhoun, Manager, Population Health Assessment - Alberta Health
Trish Merrithew-Mercredi, ADM, Public Health and Compliance – Alberta Health
Dr. Wadieh Yacoub, Senior Medical Officer of Health -FNIHB
Dr. Chris Sarin, Deputy Medical Officer of Health - FNIHB
Simon Sihota, Regional Manager, Environmental Public Health Services – FNIHB
Ibrahim Agyemang, Senior Epidemiologist - FNIHB
TSAG Telehealth Team (Michelle Hoeber, Brooke Hames and team)
FNIHB Technical Team
QUESTIONS: VCHELP@FNTN.CAQuestions?
VCHELP@FNTN.CA
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